Since it is clear that mortality rates are higher in the United States Black population and that an important disease which accounts for this is stroke, major efforts must be made to examine this differential. Stroke mortality between the ages of 35 and 74 is approximately twice as high in Blacks as in Whites. This observed difference could be attributable to racial differences and underlying pathophysiologic mechanisms which could contribute to differential prevalence and/or susceptibility to risk factors, differences in type, size, or location of stroke, or difference in the prognosis following stroke. This proposal is directed towards achieving a better understanding of racial differences in both factors leading to and the prognosis following stroke. The proposed study will be conducted in two stages, stage one involves pilot testing of protocols and all aspects of the study in the field centers. At the end of Phase I a validated and operational case identification, data collection and follow- up system will be in place in all SECONDS centers. A future Phase II study is anticipated to accrue an additional three years of data collection to achieve good statistical power for addressing this specific hypothesis of this study. This proposal is geared toward achieving a better understanding of the factors related to stroke, etiology, and prognosis to potentially allow for the implementation of more appropriate primary and secondary prevention programs across different race and gender groups.